title: Subarachnoid hemorrhage with neurocardiogenic stunning.
abstract: A well-recognized complication of acute neurologic injury from intracranial bleeding is cardiotoxicity with electrocardiographic changes and transient left ventricular dysfunction. The phenomenon, called neurocardiogenic stunning (NCS), occurs in 20% to 30% cases of patients with acute subarachnoid hemorrhage (SAH). In this article, we describe a patient with acute SAH complicated by NCS and use this case to highlight the pathogenesis, diagnostic challenges, and management dilemmas that arise in such patients. We also review conventional surgical and medical treatment and present new therapeutic options for this problem.
authors.affiliation: Department of Internal Medicine, Duke University Medical Center, Durham, NC, USA.
authors.forename: Jason J
authors.initials: JJ
authors.lastname: Rose
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Vanhecke
authors.forename: Peter A
authors.initials: PA
authors.lastname: McCullough
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000208:Acute Disease; D000368:Aged; D002533:Cerebral Angiography; D002557:Cerebrospinal Fluid Shunts; D003399:Craniotomy; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D011237:Predictive Value of Tests; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D019462:Syncope, Vasovagal / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy